Seeing a functional medicine doctor can be a very different experience than what you would typically expect from a doctor.
Functional medicine doctors take the time to get to know you, understand your health concerns in detail, and provide solutions that encompass lifestyle, nutrition, supplements, and medications, if needed. Longer appointments are key in being able to make sure you are heard without interruption.
Unfortunately, health insurance has largely dictated how long doctors can spend with their patients. This has left many patients dissatisfied with the rushed, superficial approaches they often encounter in healthcare.
Many doctors–especially those practicing functional, integrative, or naturopathic medicine–value the time they spend with their patients and don’t want insurance companies inserting themselves into the relationship. For this reason, they charge their fees directly to the patient. In most cases, severing their ties with insurance companies allows functional medicine physicians to charge less yet spend more time with their patients–a win-win.
What is involved in physician pricing?
Most holistic doctors, including those at Vytal Health, charge by the hour for their time. The reason for this is because an initial consultation is typically an hour, and patients then understand the up-front cost of that entire appointment. With traditional and insurance based billing, doctors get paid based on billing codes and their associated difficulty levels. This leads to a complete lack of transparency and and forces doctors to just check various service boxes so they can bill for them.
At Vytal Health, the initial hour-long consultation is $300. Depending on where the practice is located, functional medicine doctors’ charges can be higher or lower (national average is around $450), since doctors also have to account for the cost of their employees and office space, which can drive up the price. Because Vytal Health doctors are entirely virtual (on-line), we are able to keep our hourly prices lower than most other clinics.
Keep in mind that your out-of-pocket expenses can potentially be reimbursed by your insurance plan as an “Out of Network” benefit. Most practices, including Vytal Health, will assist you with this. Additionally, high deductible health plans often have HSA (Health Spending Accounts) or FSA (Flexible Spending Accounts) that can be used to pay for doctor visits and many other aspects of your functional medicine care.
Figuring out your budget
There are a few other things to consider when setting your budget for functional medicine care.
Many functional medicine groups, like Vytal Health, offer their care through membership plans. The reason for this is to drive a committed relationship between you and your doctor, as well as offer discounts and other perks. At Vytal Health, our plans are between $75 and $250 per month, and a discount is applied if the yearly membership is paid up-front. Which plan you choose depends on how much time you would like to spend with your doctor. If you are unsure (and most people are!), you can always talk to the doctor or the practice to get a better sense of what you might need in your membership. At Vytal Health, your doctor and care concierge will help you pick the best plan for you after your initial consultation. See our article about functional medicine memberships here.
Many of the lab tests done in functional medicine are more in-depth (and more interesting!) than you’ve typically seen from your usual doctor. Additionally, many of these tests can be performed in the comfort of your own home. Unfortunately, insurance companies have been slow to realize the importance of these tests and rarely cover them. Because you are unique, lab tests are personalized to your health condition. At Vytal Health, you can expect to pay $100-$500 per test panel and your doctor will help you prioritize which test panels you should do first. Remember that lab tests are also covered by HSA or FSA plans.
Some lab tests can be done at your clinic and be billed to your insurance company. At Vytal Health, your personal care concierge will help you figure out the best options for you.
Both functional medicine doctors and patients alike often choose to start with natural approaches to their treatment when possible, and this often involves supplements. The quality of supplements varies widely, and so does the cost. We often like to say, “the most expensive supplement is the one that doesn’t work.” At Vytal Health, we’ve heard patients describe having spent hundreds of dollars on supplements, only to abandon them one by one without success. Functional medicine doctors will typically recommend physician-grade supplements, which can be a little more pricey, but are higher quality and therefore get better results. Physician-grade supplements purchased at Vytal Health will typically cost $30-$200 per month.
We make it easier to save on cost by applying discounts with our membership, as well as packaging your supplements in daily packets. This packaging makes it easier to stick to your supplement protocol and get results.
Most medications prescribed by functional medicine doctors are covered by your insurance. Certain compounded (custom-made) medications, like bioidentical hormones or certain thyroid medications, are an out-of-pocket expense, but are typically not nearly as expensive as traditional pharmaceuticals (typically $35-50 per month). Your functional medicine doctor will discuss all of your options and certainly help steer you in the right direction if cost is an important consideration for you.
Some examples of costs
While each patient’s needs are very different, it might be helpful to get an idea of what functional medicine lab tests generally cost based on health conditions.
Example 1: Menopause and adrenal fatigue
- Testing for Suzanne was about $725.
- Supplements were about $110/mo.
- Medications (Armour thyroid and bio-identical hormones) ended up costing her around $75/mo at her local compounding pharmacy.
Because of her Vytal Health membership, Suzanne was able to save more than $400 on labs and $20/mo on supplements, making her total for all of her labs just over $300 and monthly supplement total around $90/mo.
Example 2: Depression and anxiety
- Testing for Rebecca was about $440.
- Supplements were about $130/mo.
- Rebecca did not need any medications and was able to discontinue her antidepressant.
Because of her Vytal Health membership, Rebecca was able to save $280 on labs and $25/mo on supplements, making her total for all of her labs $160 and her monthly supplement total $95/mo.
Example 3: Irritable Bowel Syndrome (IBS) and migraines
- Testing for Kathleen was about $850.
- Supplements were about $145/mo.
- Medication cost was a $10 copay at her local pharmacy.
Because of her Vytal Health membership, Rebecca was able to save $330 on labs and $30/mo on her supplements, making her total for all of her labs $520 and her monthly supplement total $115/mo.
Functional vs. traditional medicine pricing
Even though these lab tests seem quite expensive, if you have a high deductible health plan and haven’t met your annual deductible, you’ll likely pay much higher prices for similar testing in a traditional clinic’s lab, and most of the time the comprehensiveness of these types of tests aren’t available in that setting. Additionally, up-front pricing is very difficult to get in the traditional clinic or health care system, and often you don’t know the “sticker price” until the bill comes, sometimes with very unpleasant “sticker shock”!
Your functional medicine doctor should help you sort through your lab testing needs and offer you options that suit your budget, or help you prioritize the tests so that you can get the most important ones done first.
How to decide what’s best for you
If the cost of functional medicine care seems overwhelming for you, consider looking at your spending on medical care over the last year. Ask yourself whether the care you received was helpful, or if you felt supported and cared for. Was the treatment effective?
Add in the cost of supplements and over-the-counter medications you may have purchased on your own, or at the suggestion of a friend or family member. When you look closely at what you are typically spending on health care, it might surprise you to find out that functional medicine care is more within reach than you thought.
If you’re not sure about committing to functional medicine care, some practices like Vytal Health offer a no-strings-attached initial visit with a physician to make sure it is right for you before you commit to a membership.